A recent case of vaccine compensation in the US has been picked up by the UK media, notably the Daily Express, and is being touted as evidence that vaccines cause autism.

Paul Offit provides a commentary in The New England Journal of Medicine on the Hannah Poling case, and explains how the US vaccination compensation scheme has abandoned science over the years.

the VICP’s concession to Hannah Poling was poorly reasoned. First, whereas it is clear that natural infections can exacerbate symptoms of encephalopathy in patients with mitochondrial enzyme deficiencies, no clear evidence exists that vaccines cause similar exacerbations. Indeed, because children with such deficiencies are particularly susceptible to infections, it is recommended that they receive all vaccines.

Second, the belief that the administration of multiple vaccines can overwhelm or weaken the immune system of a susceptible child is at variance with the number of immunologic components contained in modern vaccines. A century ago, children received one vaccine, smallpox, which contained about 200 structural and nonstructural viral proteins. Today, thanks to advances in protein purification and recombinant DNA technology, the 14 vaccines given to young children contain a total of about 150 immunologic components.

Third, although experts testifying on behalf of the Polings could reasonably argue that development of fever and a varicella-vaccine rash after the administration of nine vaccines was enough to stress a child with mitochondrial enzyme deficiency, Hannah had other immunologic challenges that were not related to vaccines. She had frequent episodes of fever and otitis media, eventually necessitating placement of bilateral polyethylene tubes. Nor is such a medical history unusual. Children typically have four to six febrile illnesses each year during their first few years of life; vaccines are a minuscule contributor to this antigenic challenge.

Fourth, without data that clearly exonerate vaccines, it could be argued that children with mitochondrial enzyme deficiencies might have a lower risk of exacerbations if vaccines were withheld, delayed, or separated. But such changes would come at a price. Even spacing out vaccinations would increase the period during which children were susceptible to natural infections, giving a theoretical risk from vaccines priority over a known risk from vaccine-preventable diseases. These diseases aren’t merely historical: pneumococcus, varicella, and pertussis are still common in the United States. Recent measles outbreaks in California, Arizona, and Wisconsin among children whose parents had chosen not to vaccinate them show the real risks of public distrust of immunization.

Offit believes that the US vaccine compensatory scheme should be more stringent.

Going forward, the VICP should more rigorously define the criteria by which it determines that a vaccine has caused harm. Otherwise, the message that the program inadvertently sends to the public will further erode confidence in vaccines and hurt those whom it is charged with protecting.

Readers may be interested to note that short-book reviews can be inserted into amazon urls. I have taken off the catalogue numbers for the purposes of display within the column of this blog, but clicking through to amazon will show the effect in your address bar.

For example:

http://www.amazon.co.uk/Ben_Goldacre_is_everywhere_like_God

http://www.amazon.co.uk/how-to-exploit-the-sick-for-profit

http://www.amazon.co.uk/most_alternative_medicine_is_a_pile_of_crap

http://www.amazon.co.uk/an-attempt-to-kill-children-with-pseudoscience

http://www.amazon.co.uk/Boris_Johnson_blunders_again

I’m sure people can think of better ones than that.

The above is taken from a BBC news report on a BMA report which suggests that doctors should encourage parents to vaccinate their children, and which says that vaccination “is the safest and most effective way of preventing infectious diseases”.

Why are the BBC still providing links, and directing parents, to an anti-vaccine website which promotes scientific quackery? Do they believe an organisation which carriesarticles such as VACCINATION - 100 Years of Orthodox Research shows that Vaccines Represent a Medical Assault on the Immune System has anything useful to contribute?

Vaccines are highly noxious. They contain formaldehide, aluminium phosphate, thiomersal (mercury compound), foreign proteins (antigens) and, contaminating animal proteins and viruses from the tissues used as growth medium on which to culture the viral and bacterial components of the vaccines.

None of these substances should ever be injected into human beings. They erode the immune system and alter the immunological response to diseases. The appearance of many new, autoimmune diseases like asthma, affecting almost every child, childhood leukaemia and cancer, the enormous upsurge in the incidence of cerebral palsy and infantile convulsions seen in children of vaccination age and not before, should all be taken as serious warnings that medicine should look into properly and appropriately treating infectious diseases of childhood, rather than attempting to “erradicate” them.

The first batches of polio vaccine, used in mass proportions in some countries of Africa in the nineteen fifties was grown on monkey kidneys from which simian immunodeficiency viruses have been cultured. This provides the causal link to AIDS .

Infectious diseases of childhood are beneficial when contracted at a suitable age and allowed to run their natural course - these diseases serve to prime and mature the immune system of children.

Contrast this with the links provided in a recent story on global warming. No links are given to sites skeptical about global warming, still less one as scientifically illiterate and conspiracy theory-driven as JABS. This is presumably, because the BBC have decided that there is no “balance” issue in climate science. Quite why the BBC have differing standards over vaccination is not clear.

Sunder Katwala, secretary-general of the Fabian Society, has a post up at Liberal Conspiracy concerning MMR vaccination, and possible mechanisms for increasing uptake. One of the mechanisms put forward, by Mary Creagh MP, is:

She also proposes making MMR catch-up sessions for five year olds standard in every part of the country before they start school, and asks whether Britain should emulate the US policy where, alongside moves to ensure that low income children are not left unvaccinated, children can only start school where parents provide proof of vaccination (with exemptions on medical or religious grounds).

Sunder also points to the Canadian approach to vaccination, where there is no compulsion on parents to vaccinate, but those who do not wish to vaccinate their children have to actively opt-out of vaccination. Proof of vaccination is required for entrance to school, but parents who wish to avoid immunising their child have to sign documents to back-up their decision. There is no passive sliding into non-immunisation, as occurs in the UK.

Such a system is far from being compulsory, or Stalinist as the BMA have ridiculously suggested (in the process echoing past right-wing libertarian BMA concerns about state control they expressed prior to the formation of the NHS):

Dr Hamish Meldrum, chairman of the BMA, said forcing parents to have children immunised was “morally and ethically dubious” and would go “beyond the nanny state to a police state”.

Compulsory vaccination is undefendable on a number of grounds, both in terms of democratic politics and personal autonomy over one’s health. However, there should also be concerns about any plans to link schooling to vaccination policy:

1. The effects of the MMR-autism hoax has started to subside. It is possible that the situation will improve without changes to vaccination policy, although of course uptake is still too low in many areas.
2. The scientific evidence is now conclusive. Objections to MMR vaccine are now based on conspiracy theories or suggestions of conflicts of interest. Changing vaccination policy may re-enforce this viewpoint - and current press coverage in the Daily Express seems to support this view.
3. The wider political climate. There is a feeling that the current Labour government is authoritarian in nature. There are concerns about detention with trial, the number of CCTV cameras on streets, and ID cards. Changes in vaccination policy are likely to be viewed in that context, and therefore may be counterproductive. Vaccination would be best kept out of the current troubles that the Brown government are suffering.

So although I am open to Creagh’s suggestion, so long as no compulsion is involved, I think that such a move would be counterproductive in terms of the public perception of vaccines. It could potentially undermine an argument that science has only just started to win.

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So now we know. According to Cherie Blair, who has exposed her susceptibility to woo by using crystal therapy, Leo Blair did have the MMR jab:

In early December the Daily Mail ratcheted up its attacks on me. They demanded to know whether [Leo] had had the MMR vaccine. “Come Clean, Cherie” was the headline. The great issue of the day was whether the MMR vaccine caused autism. A report - since wholly discredited - had said that it did. Then the Mirror joined in. I had innocently responded to a letter sent to me by the mother of an autistic child, saying I was “keeping an eye on things”.

A number of people around me, whose views I respected, were vociferously against all forms of vaccination. Over the years I had listened to their side of the argument and, it’s fair to say, I was in two minds. I did get Leo vaccinated, not least because it’s irresponsible not to - there’s absolutely no doubt that the incidence of disease goes up if vaccinations go down - and he was given his MMR jab within the recommended time-frame. I was adamant, however, that I would not give the press chapter and verse. They had no right and it would set a bad precedent, and everyone - by which I mean Alastair and Fiona - agreed.

Prior reports have already suggested that Leo was vaccinated.

At the time of the initial controversy Catherine Bennett of The Guardian said:

non-disclosure will be taken to mean that Leo has not been done, or done privately in single doses, and a sure sign that there is something dodgy about MMR vaccinations.

Just showing that paranoid cynicism isn’t always right.

I still have some sympathy with the view that the Blairs were correct not to enter into a debate orchestrated by newspapers with an axe to grind, because of the precedent it might set. Given the vaccination schedule, and other potential health problems children can have, it would mean that the children of politicians could be targeted over and over again in the media in a sort of voyeuristic anecdotalism. Blair stated his support for the MMR policy on numerous occasions. That should have been taken as the final word.

Just testing Podpress. Risk-benefit discussion from American Cliche.

 

 Good old-fashioned jacked-up antibiotics: Play Now | Play in Popup | Download

I’ve just updated to Wordpress 2.5.1. Glitches may occur, though it looks nice at this end.

UPDATE: I’ve also changed templates (although this one requires some customisation). Comments on the new template and how the old template was better, and how people shouldn’t muck about with things, are welcome.

When science is politicized, when the truth is subjugated by ideology, it’s worse than wrong — it’s dangerous. Ending the war on science and once again valuing the ever-skeptical but always hopeful scientific enterprise is about more than our economy. It’s about more than our security. It is about our democracy.

Hillary Clinton, 2007.

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Today I visited the Oxford University Museum of Natural History, lots of nice things there. Like dinosaurs, Charles Darwin and Newton’s Apple. Rest of photographs here.